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Organization
RITE AID PHARMACY
Active
Organization
RITE AID PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW MICHAEL LYSOGORSKI PHARMD (STAFF PHARMACIST)
(518) 641-2828
Entity
Organization
Contact information
Practice address
284 CONNECTICUT ST, BUFFALO, NY 14213-2542
(716) 881-4007
Mailing address
346 CONNECTICUT ST, APT 302, BUFFALO, NY 14213-2900
(716) 881-4007
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
059357
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1576493
—
NY
Enumeration date
06/09/2015
Last updated
06/09/2015
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